Splenic artery aneurysms during pregnancy: An obstetric nightmare

Objective: In this study we report our experience in the management of Splenic Artery Aneurysm (SAA), diagnosed during pregnancy. Study Design: The current manuscript describes three different events, treated in out our department, involving SAAs diagnosed during pregnancy. Each case presents an unusual course and a unique clinical challenge. Results: The first case is of a 25 week's gestation twin pregnancy with ruptured SAA ending in maternal and fetal death. Another case of SAA rupture presented at 27 week's gestation with consequent emergency cesarean section and splenectomy. In the last case, two SAAs were incidentally diagnosed at 25 weeks' singleton gestation. The patient was managed conservatively and delivered by an elective cesarean section at 34 weeks followed by postpartum angiographic embolization of the aneurysms. Conclusions: Health care providers and especially obstetricians should be aware of the diagnosis of ruptured SAA in a pregnant woman with abdominal discomfort and hemodynamic deterioration. In addition, once an asymptomatic pregnant patient is diagnosed with a SAA, conservative surveillance may be allowed.